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S42.434B vs S42.435B

S42.434B (Nondisplaced fracture (avulsion) of lateral epicondyle of right humerus, initial encounter for open fracture) compared with S42.435B (Nondisplaced fracture (avulsion) of lateral epicondyle of left humerus, initial encounter for open fracture), from the official CMS tabular data. S42.434B and S42.435B code the same condition on opposite sides. MedCoder-derived

Relationship

Review

Laterality relationship

S42.434B
Right
Nondisplaced fracture (avulsion) of lateral epicondyle of right humerus, initial encounter for open fracture
S42.435B
Left
Nondisplaced fracture (avulsion) of lateral epicondyle of left humerus, initial encounter for open fracture

Same condition; these differ only in which side is documented.

These codes share a category and title and differ only in the side affected. The documentation decides which applies, and a bilateral code is reported only where the code set provides one.

Source: ICD-10-CM tabular list (laterality variant derived from the code title)

Can these codes be reported together?

Same condition, opposite side. S42.434B and S42.435B name the same condition on opposite sides of the body.

Same category and title, differing only in which side is affected — the documentation decides which one applies, and a bilateral code is reported only where the code set provides one.

Side by side

S42.434BNondisplaced fracture (avulsion) of lateral epicondyle of right humerus, initial encounter for open fractureS42.435BNondisplaced fracture (avulsion) of lateral epicondyle of left humerus, initial encounter for open fracture
Billing statusBillableBillable
ClassificationS00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88)
DefinitionNondisplaced fracture (avulsion) of lateral epicondyle of right humerus, initial encounter for open fracture is a billable ICD-10-CM diagnosis code (S42.434B).Nondisplaced fracture (avulsion) of lateral epicondyle of left humerus, initial encounter for open fracture is a billable ICD-10-CM diagnosis code (S42.435B).
7th characterThe appropriate 7th character is to be added to all codes from category S42The appropriate 7th character is to be added to all codes from category S42
Includes
injuries of axilla
injuries of scapular region
injuries of axilla
injuries of scapular region

Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources